I guess there's absolutely nothing stopping websites from selling ad space on their websites directly and managing them internally, missing out on the ad networks and all the privacy invasive cross tracking and jars full of cookies tracking all number of things that people are increasingly fed up with. Not to mention the slow downs and resource hogging with the current script after script after script.
Granted it won't be as powerful as far as targetting is concerned but there's no reason it can't easily monitor click throughs against impressions and whereever the links go off to can easily check their performance also.
Seems a better solution to me, back to basics and missing out any number of middle men in the ad networks. Granted a lot of potential job losses there but who will be sad about the death of some of those marketing companies..